Reminders of progress made in advancing public health are always important to acknowledge, if only as a reminder of how much more we can accomplish. A new report from the American Cancer Society provides such news. According to the report, the death rate of cancer, the second-leading cause of death among Americans, has drastically declined over the past 25 years. It dropped by 27 percent between 1991 and 2016. According to American Cancer Society estimates, the steadily declining cancer mortality rates saved about 2.6 million lives between 1991 and 2016.

According to data provided by the National Center for Health Statistics, a significant reduction in lung cancer mortality – along with improvements in cancer screening and treatment – accounted for a large percentage of the overall decline. As smoking rates have fallen dramatically in recent years, so have incidents of lung cancer deaths.

Smoking rates have traditionally been higher among men than women, but male death rates have fallen dramatically. Adult male death rates fell by 48 percent between 1990 and 2016, compared to a 23 percent drop among women during the same period.

Racial disparities in cancer mortality are also narrowing. In 2016, black Americans were still approximately 14 percent more likely to die from cancer than white Americans were, but that number represents a sizable drop from the 33 percent reported 25 years ago. According to the report, lower smoking rates among young black Americans largely explain the progress made in narrowing the gap.

Let’s take a moment to reflect just how far we have come in stopping the smoking habit and improving public health as a result. When I was a kid in the 1960s, roughly 42 percent of U.S. adults smoked. Tobacco was seemingly everywhere you turned during the ’60s. There might as well have been cigarette vending machines in school hallways.

According to a recent Associated Press report, approximately 14 percent of U.S adults were smokers last year, a 2 percent decline from the year before and the lowest percentage in memory. Teen smoking also continued to decline. New figures from the tobacco research program at the Medical University of South Carolina show smoking among high school students is down to 9 percent, which represents an all-time low since such data has been tracked.

Anti-smoking campaigns, cigarette taxes and smoking bans have cumulatively brought down these rates, researchers say. That said, there still remain an estimated 37.8 million adult smokers in this country. According to the U.S. Department of Health and Human Services, as recently as 2017, roughly 3.6 million middle and high school students were using tobacco.

As I reported last week, according to data from the Food and Drug Administration and the Centers for Disease Control and Prevention, between 2011 and 2018, nearly 21 of every 100 high school students surveyed reported e-cigarette use in a 30-day period. In a one-year period ending from 2017 to 2018, there occurred the biggest one-year spike in substance use of any kind in the 44 years of monitoring substance abuse among young people. In response, the U.S. surgeon general called the 78 percent increase in teen vaping a crisis of epidemic proportion.

Research shows that most smokers start before they are 21. Kids who pick up the vaping habit are said to be four times more likely to ultimately become cigarette smokers. If we do not move quickly to address this situation, these gains in smoking cessation and overall public health may soon be in jeopardy as Big Tobacco reaps a new generation of customers hooked on nicotine. Keep in mind that research shows children and young adults to be more susceptible than older people to nicotine’s addictive effects. If current statistics hold, according to the CDC, 5.6 million youth who are alive today will die from tobacco-related diseases.

On a separate – and little-noticed – front, the surgeon general’s report also warned that exposure to smoking in movies has historically caused young people to start smoking and that such on-screen depictions in top-grossing movies in the U.S. are once again on the rise, breaking an earlier decline.

A study by the University of California, San Francisco and the CDC shows an explosion of smoking depictions in upcoming Oscar-nominated films. An estimated 86 percent of this year’s films listed in major categories feature smoking, up 60 percent from four years ago. Kid-friendly films on the Oscar list feature twice as much smoking as they did in 2017. According a National Cancer Institute report, young people who are heavily exposed to smoking depictions in movies are two to three times more likely to start smoking, compared with kids who have had little such exposure. According to the study, the total number of tobacco incidents in top-grossing movies increased 72 percent between 2010 and 2016.

Is this mere coincidence?

The tobacco industry is not known to stand idly by while market share and cigarette sales continue to decline. In addition to the billions they are now investing in popular vaping devices, they have always shown cunning skill at constructing and cultivating a celebrity culture to influence social behavior in their favor. If we are to reverse this current assault, and are relying on the federal government, keep in mind Big Tobacco’s clout and track record for undercutting public health efforts and regulatory interventions. Be prepared to act locally.